the Impact of Non-Surgical Treatment for Wrist Fractures - Orthopedics

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Inquiry about distal radius fracture (bone separation) issues?


The attached image shows two different opinions from doctors.
One suggests that surgery is an option but not mandatory, noting that if surgery is not performed, there may be a decrease in physical flexibility, but the patient can still make a fist.
The other doctor insists that surgery is necessary, stating that without it, the hand will not only be less flexible but also unable to form a normal fist.

So, if surgery is not performed, what impacts could arise? (It has been 5 days since the incident, and the hand is still swollen and in a cast, making it impossible to make a fist.) Thank you.

k, 60~69 year old female. Ask Date: 2016/05/13

Dr. Chen Yongxue reply Orthopedics


I didn't see the attachment!

Reply Date: 2016/05/13

More Info


When it comes to wrist fractures, the decision to pursue surgical or non-surgical treatment can significantly impact recovery, functionality, and overall quality of life. Based on the information provided, it seems that there are differing opinions among medical professionals regarding the necessity of surgery for your wrist fracture. Here’s a comprehensive analysis of the implications of non-surgical treatment for wrist fractures, particularly in the context of your situation.


Understanding Non-Surgical Treatment for Wrist Fractures
1. Nature of the Fracture: The type and severity of the fracture play a crucial role in determining the treatment approach. Non-displaced fractures, where the bone fragments remain aligned, may heal well with conservative treatment such as immobilization in a cast. However, displaced fractures, where the bone fragments are misaligned, often require surgical intervention to restore proper alignment and function.

2. Potential Consequences of Non-Surgical Treatment:
- Healing and Recovery: Non-surgical treatment typically involves immobilization with a cast or splint. While this can allow for healing, it may not guarantee optimal alignment of the bones. If the fracture is not properly aligned, it can lead to malunion (healing in an incorrect position) or nonunion (failure to heal), which may necessitate future surgical intervention.

- Functional Limitations: As you mentioned, one of the concerns with non-surgical treatment is the potential for decreased range of motion and strength in the wrist. This can affect daily activities, including the ability to grip or perform fine motor tasks. If the fracture does not heal correctly, you may experience long-term limitations in wrist function, which could impact your quality of life.

- Pain and Swelling: Persistent swelling and pain, as you are currently experiencing, can be common in wrist fractures, especially in the initial stages. While some swelling is expected, prolonged swelling may indicate complications such as improper healing or the development of reflex sympathetic dystrophy (RSD), a condition that can cause chronic pain and mobility issues.

3. Rehabilitation and Recovery: If you choose non-surgical treatment, rehabilitation becomes crucial. Physical therapy can help restore range of motion, strength, and function once the fracture has healed sufficiently. However, if the fracture heals improperly, rehabilitation may be less effective, and you may not regain full function.

4. Monitoring and Follow-Up: Regular follow-up appointments with your healthcare provider are essential to monitor the healing process. If there are signs of malunion or complications, timely intervention can be critical. Imaging studies, such as X-rays, may be necessary to assess the alignment of the bones during the healing process.

5. Long-Term Considerations: If non-surgical treatment leads to complications, you may face long-term consequences, including chronic pain, arthritis, or decreased functionality in the wrist. These issues can arise years after the initial injury and may require further treatment, including surgery.


Conclusion
In summary, while non-surgical treatment for wrist fractures can be effective in certain cases, it carries risks that can affect your long-term functionality and quality of life. If your fracture is displaced or if there are concerns about proper healing, surgical intervention may be the more prudent choice to ensure optimal recovery. It is essential to have open and ongoing discussions with your healthcare provider about your treatment options, potential outcomes, and the importance of follow-up care. If you continue to experience significant swelling and inability to move your wrist, it may warrant further evaluation to determine the best course of action for your recovery.

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